Predictors of adherence to statins for primary prevention

Cardiovasc Drugs Ther. 2007 Aug;21(4):311-6. doi: 10.1007/s10557-007-6040-4.


Purpose: Statins are potent drugs for reducing cholesterol and cardiovascular disease; however, their effectiveness is significantly compromised by poor adherence. This prospective study was designed to identify potentially modifiable patient factors including medication, disease, and diet beliefs related to statin adherence.

Methods: Veterans (n = 71) given their first prescription of a statin for primary prevention were interviewed at baseline, 3 months, and 6 months regarding medication, disease, and diet beliefs along with self-reported statin adherence.

Results: At 6-month follow-up, 55% of the cohort was non-adherent with 10% reporting never having started their statin, 50% reporting misconceptions about the duration of treatment and a median use of <2 months among those who discontinued their statin. Multivariate predictors of non-adherence were expected short treatment duration (OR = 3.6, 1.4-9.4), low perceived risk of myocardial infarction (OR = 3.1, 1.1-8.7), concern about potential harm from statins (OR = 2.5, 1.0-6.3), being Hispanic (OR = 3.9, 1.0-15.2), and younger age (OR = 4.2, 1.1-15.8).

Conclusions: Poor adherence to statins was common in this primary prevention population with frequent early discontinuation despite access to low-cost medicines. Patient factors regarding the perception of risk, toxic effects of medication, expected treatment duration, as well as socio-demographic factors, were significant predictors of poor adherence and warrant further exploration.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cardiovascular Diseases / prevention & control*
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice*
  • Hospitals, Veterans
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypercholesterolemia / drug therapy*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Compliance / psychology*
  • Primary Prevention
  • Prospective Studies
  • Risk Factors
  • Treatment Refusal / psychology
  • Veterans


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors